Bill 130 Is Useless According to the FMSQ
Montreal, February 14, 2017 – In the presence of the members of the Committee on Health and Social Services during the special consultations and public hearings on Bill 130, An Act to amend certain provisions regarding the clinical organization and management of health and social services institutions, the Fédération des médecins spécialistes du Québec (FMSQ) strongly proclaimed the uselessness of this Bill, and the inadmissible nature of some of its provisions.
"One has to deliberately ignore the reality in the field and in the practice of specialized medicine in a hospital centre to declare that physicians do not report to anyone and that they have no obligations whatsoever towards the establishments in which they practise. Physicians already have rules to which they are held and, whether the Minister likes it or not, the practice of medicine is already self-regulated.
"The current legislative and regulatory framework is largely sufficient to allow for the optimization of resources used. These rules deal with on-call duties to be covered at all times, the continuing evaluation of the quality of medical acts, teaching and research activities both clinical and fundamental, the maintenance of professional competence, the development and application of rules regarding the use of resources, the implementation of rules directing the dispensation of care, and investigative and treatment protocols," admonished the President of the FMSQ, Dr Diane Francœur.
"Physicians practising in hospitals don't have to report to anyone and have no obligations ? Nothing is further from the truth ! Departments don't work solely under the impetus of administrators and managers. Imagine if clinical decisions, case-handling protocols, the organization of care, the various training, teaching and research programs, the prioritization of cases and hospitalizations depended only on administrators. Hospitals would have already closed their doors a long time ago," continued the President of the FMSQ.
For the FMSQ, postulating that physicians are not subject to the network's directions because they are not salaried employees constitutes THE ideal pretext to question their status as independent professionals.
"This status is not the result of a passing fancy. It is the bulwark protecting the physician's independence in the practice of his or her profession. It is thanks to this independence that the physician can act in the sole interest of his or her patient. This status prevents a physician's decision-making authority from being subordinated to that of an employer in the choice of a test, examination, treatment, procedure, intervention or care," explained Dr Francœur.
Generalizing from Exceptions
The Minister of Health as well as opposition party MNAs use cases that are exceptions, or just anecdotes, to support their arguments in their aim to justify the adoption of this Bill. Reference is made to a fictional department head who, wanting to maximize the use of his operating theatres, could not force surgeons to work later in the evenings or during weekends. "In real life, in hospital centres throughout Quebec, surgical times are amputated every day strictly for budgetary reasons. Decisions are made not by department heads, but by hospital management," continued the President of the FMSQ.
Too Much Power in the Hands of a Single Person
"As was the case with Laws 10, 20 and 92, as well as Bill 118, the Minister takes advantage of this Bill to assume a slew of new powers, as if those that are already granted to him by the current provisions of the law are not largely sufficient to allow him to adequately discharge his duties. Adopting this Bill would increase the Minister's powers of intervention which are already excessive, even abusive. In addition to presenting a real risk of excesses, such a concentration of powers in the hands of a single person opens the door to an extreme politicization of the healthcare network," concluded Dr Francœur.
The FMSQ's white paper is available on its portal at fmsq.org (in French only).
The Fédération des médecins spécialistes du Québec represents more than 10,000 medical specialists certified in one of the 59 recognized medical specialties.